MEDICARE: W. GUINN PAULK, M.D., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	16479	AL

General Provider Information

NPI Number	:	1134155427
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	W. GUINN PAULK, M.D., P.C.

Provider Business Mailing Address
First Line	:	262 MITYLENE PARK DR
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36117-3548
Country	:	US
Telephone Number	:	334-260-8511
Fax Number	:	334-260-8755

Provider Business Practice Location Address
First Line	:	262 MITYLENE PARK DR
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36117-3548
Country	:	US
Telephone Number	:	334-260-8511
Fax Number	:	334-260-8755

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. NANCY PAULK
Credential	:
Telephone Number	:	334-260-8511

Provider Enumeration Date	:	06/25/2006
Last Update Date	:	01/23/2008

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